ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
Reported Tuberculosis Symptoms: An Inadequate Classifier of Disease State.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Multimorbidity care during TB treatment: no longer if, but how.IJTLD open · 2026Article
- Longitudinal Symptom Transitions Predict Incident Tuberculosis Risk in Serial Active Case Finding.The Journal of infectious diseases · 2026Article
- Within-household transmission risk of pulmonary tuberculosis in the era of universal antiretroviral therapy.medRxiv : the preprint server for health sciences · 2026Article
- Mycobacterium tuberculosis transmission from tuberculosis patients with and without recognized symptoms: a case-contact study in eastern China.Nature communications · 2026Article
- Transmissibility and Disease Progression of Asymptomatic Mycobacterium tuberculosis Infection, Lima, Peru.Emerging infectious diseases · 2026Article
- Projected population level impact and cost-effectiveness of clinic and community-based tuberculosis screening approaches.PLOS global public health · 2026Article
- Research overview-2025: integrating scientific progress to accelerate global tuberculosis elimination.Frontiers in tuberculosis · 2026Article
- Comment on: Precision geospatial targeting for cost-effective tuberculosis case finding in Eastern Uganda: A quasi-experimental study.Therapeutic advances in infectious diseaseArticle
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Authors and funding
6 authors.
Funding
Abstract
Around half of people identified with tuberculosis (TB) during prevalence surveys do not report symptoms, prompting increased interest in the public health implications of asymptomatic TB (aTB), as distinct from symptomatic TB (sTB). A recent World Health Organization report proposes investigating the optimal treatment for aTB, stratifying notification data by symptom status, and publishing incidence estimates based on sTB. We have concerns that the proposed use of aTB/sTB case definitions for surveillance, burden estimation, and clinical management is not supported by evidence. Although TB symptoms are linked to disease severity, we show that self-reported symptoms are an inadequate classifier of disease state, heavily influenced by context and substantial interviewer variability, and TB symptoms may frequently have alternative causes. We advocate for the adoption of more robust measures of severity, better reflecting underlying pathophysiology. Research on the TB disease spectrum should prioritize more objective severity metrics, alongside or instead of symptom-based classification.
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